Safety and effectiveness of video-assisted thoracoscopic surgery pneumonectomy for bronchiectasis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIAO Hu , XIAO Zhilan , GUO Chenglin , WU Zhu , CHE Guowei , KOU Yingli , PU Qiang , MA Lin , LIU Chengwu ,  LIU Lunxu

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Video-assisted thoracoscopic surgery; pneumonectomy; thoracotomy; bronchiectasis

DOI：

10.7507/1007-4848.201805044

Video：

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Objective To explore the safety and effectiveness of video-assisted thoracoscopic surgery (VATS) pneumonectomy for bronchiectasis.Methods The clinical data of 164 patients undergoing VATS pneumonectomy or open thoracotomy for bronchiectasis in our hospital from March 2002 to July 2012 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods: a thoracotomy group (122 patients, 63 males, 59 females) and a thoracoscopic surgery group (42 patients, 15 males, 27 females). Surgical and follow-up indicators were compared between the two groups.Results There was no difference between the two groups in the blood loss, operation time, perioperative mortality or complication. However patients undergoing VATS had shorter length of postoperative stay than those undergoing thoracotomy (6.9±2.6 d vs. 8.1±3.1 d, P=0.030). In the thoracoscopic surgery group, 3 patients were lost to follow-up and in the thoracotomy group, 5 patients were lost to follow-up. In a median follow-up of 51 months (ranging from 2 to 116 months), 36 patients (92.3%) fully recovered with no sputum or haemoptysis and 3 (7.7%) partially recovered with a reduced sputum or haemoptysis in the thoracoscopic surgery group; 105 (89.7%) fully recovered with no sputum or haemoptysis, 10 (8.5%) partially recovered with a reduced sputum or haemoptysis while 2 (1.7%) without any improvement in the thoracotomy group with no statistical difference (P=0.700).Conclusion VATS pneumonectomy for bronchiectasis is equivalent to thoracotomy in terms of safety and effectiveness, and can be used as an alternative surgical procedure for the treatment of bronchiectasis.

Citation： LIAO Hu, XIAO Zhilan, GUO Chenglin, WU Zhu, CHE Guowei, KOU Yingli, PU Qiang, MA Lin, LIU Chengwu, LIU Lunxu. Safety and effectiveness of video-assisted thoracoscopic surgery pneumonectomy for bronchiectasis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(6): 574-577. doi: 10.7507/1007-4848.201805044 Copy

1.	Schneiter D, Meyer N, Lardinois D, et al. Surgery for non-localized bronchiectasis. Br J Surg, 2005, 92(7): 836-839.
2.	O'Donnell AE. Bronchiectasis. Chest, 2008, 134(4): 815-823.
3.	Pasteur MC, Bilton D, Hill AT, et al. British Thoracic Society guideline for non-CF bronchiectasis. Thorax, 2010, 65 Suppl 1: i1-i58.
4.	蒲強, 馬林, 梅建東, 等. 全胸腔鏡與后外側開胸對肺癌患者免疫功能影響的對比研究. 四川大學學報(醫學版), 2013, 44(1): 126-129.
5.	Weber A, Stammberger U, Inci I, et al. Thoracoscopic lobectomy for benign disease--a single centre study on 64 cases. Eur J Cardiothorac Surg, 2001, 20(3): 443-448.
6.	Yim AP. The role of video-assisted thoracoscopic surgery in the management of pulmonary tuberculosis. Chest, 1996, 110(3): 829-832.
7.	劉倫旭, 車國衛, 王允, 等. 電視胸腔鏡手術治療肺良性疾病 128 例. 中國胸心血管外科臨床雜志, 2008, 15(1): 29-31.
8.	蒲強, 劉倫旭, 車國衛, 等. 單向式全胸腔鏡肺葉切除手術治療肺良性疾病的臨床研究. 四川大學學報(醫學版), 2010, 41(3): 548-550.
9.	Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
10.	蒲強, 梅建東, 廖虎, 等. 全胸腔鏡解剖性肺段切除治療肺部疾病的早期結果. 中華外科雜志, 2012, 50(9): 823-826.
11.	Demmy TL, Nwogu C. Is video-assisted thoracic surgery lobectomy better? Quality of life considerations. Ann Thorac Surg, 2008, 85(2): S719-S728.
12.	Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
13.	Zhang W, Wei Y, Jiang H, et al. Video-assisted thoracoscopic surgery versus thoracotomy lymph node dissection in clinical stage Ⅰ lung cancer: A meta-analysis and system review. Ann Thorac Surg, 2016, 101(6): 2417-2424.
14.	劉成武, 郭成林, 林鋒, 等. 單向式胸腔鏡肺葉或肺段切除術治療Ⅰ期肺癌的遠期療效. 中華外科雜志, 2015, 53(10): 742-746.
15.	Yim AP. VATS major pulmonary resection revisited--controversies, techniques, and results. Ann Thorac Surg, 2002, 74(2): 615-623.
16.	Zhang P, Zhang F, Jiang S, et al. Video-assisted thoracic surgery for bronchiectasis. Ann Thorac Surg, 2011, 91(1): 239-243.
17.	苗勁柏, 孫鳳華, 張文謙, 等. 全胸腔鏡肺葉切除術治療支氣管擴張癥的臨床研究. 中國胸心血管外科臨床雜志, 2012, 19(4): 395-398.
18.	Li SJ, Zhou K, Li YJ, et al. Efficacy of the fissureless technique on decreasing the incidence of prolonged air leak after pulmonary lobectomy: A systematic review and meta-analysis. Int J Surg, 2017, 42: 1-10.
19.	Ng T, Ryder BA, Machan JT, et al. Decreasing the incidence of prolonged air leak after right upper lobectomy with the anterior fissureless technique. J Thorac Cardiovasc Surg, 2010, 139(4): 1007-1011.

1. Schneiter D, Meyer N, Lardinois D, et al. Surgery for non-localized bronchiectasis. Br J Surg, 2005, 92(7): 836-839.
2. O'Donnell AE. Bronchiectasis. Chest, 2008, 134(4): 815-823.
3. Pasteur MC, Bilton D, Hill AT, et al. British Thoracic Society guideline for non-CF bronchiectasis. Thorax, 2010, 65 Suppl 1: i1-i58.
4. 蒲強, 馬林, 梅建東, 等. 全胸腔鏡與后外側開胸對肺癌患者免疫功能影響的對比研究. 四川大學學報(醫學版), 2013, 44(1): 126-129.
5. Weber A, Stammberger U, Inci I, et al. Thoracoscopic lobectomy for benign disease--a single centre study on 64 cases. Eur J Cardiothorac Surg, 2001, 20(3): 443-448.
6. Yim AP. The role of video-assisted thoracoscopic surgery in the management of pulmonary tuberculosis. Chest, 1996, 110(3): 829-832.
7. 劉倫旭, 車國衛, 王允, 等. 電視胸腔鏡手術治療肺良性疾病 128 例. 中國胸心血管外科臨床雜志, 2008, 15(1): 29-31.
8. 蒲強, 劉倫旭, 車國衛, 等. 單向式全胸腔鏡肺葉切除手術治療肺良性疾病的臨床研究. 四川大學學報(醫學版), 2010, 41(3): 548-550.
9. Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
10. 蒲強, 梅建東, 廖虎, 等. 全胸腔鏡解剖性肺段切除治療肺部疾病的早期結果. 中華外科雜志, 2012, 50(9): 823-826.
11. Demmy TL, Nwogu C. Is video-assisted thoracic surgery lobectomy better? Quality of life considerations. Ann Thorac Surg, 2008, 85(2): S719-S728.
12. Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
13. Zhang W, Wei Y, Jiang H, et al. Video-assisted thoracoscopic surgery versus thoracotomy lymph node dissection in clinical stage Ⅰ lung cancer: A meta-analysis and system review. Ann Thorac Surg, 2016, 101(6): 2417-2424.
14. 劉成武, 郭成林, 林鋒, 等. 單向式胸腔鏡肺葉或肺段切除術治療Ⅰ期肺癌的遠期療效. 中華外科雜志, 2015, 53(10): 742-746.
15. Yim AP. VATS major pulmonary resection revisited--controversies, techniques, and results. Ann Thorac Surg, 2002, 74(2): 615-623.
16. Zhang P, Zhang F, Jiang S, et al. Video-assisted thoracic surgery for bronchiectasis. Ann Thorac Surg, 2011, 91(1): 239-243.
17. 苗勁柏, 孫鳳華, 張文謙, 等. 全胸腔鏡肺葉切除術治療支氣管擴張癥的臨床研究. 中國胸心血管外科臨床雜志, 2012, 19(4): 395-398.
18. Li SJ, Zhou K, Li YJ, et al. Efficacy of the fissureless technique on decreasing the incidence of prolonged air leak after pulmonary lobectomy: A systematic review and meta-analysis. Int J Surg, 2017, 42: 1-10.
19. Ng T, Ryder BA, Machan JT, et al. Decreasing the incidence of prolonged air leak after right upper lobectomy with the anterior fissureless technique. J Thorac Cardiovasc Surg, 2010, 139(4): 1007-1011.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Safety and effectiveness of video-assisted thoracoscopic surgery pneumonectomy for bronchiectasis

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